Brandon-Evansville Bullying/Incident Report Form
At the Brandon-Evansville School District Courage, Honesty, Accountability, Respectfullness, Graciousness, & Excellence are all characteristics that are expected from students and staff. Please use this form to share your concern. This report will reviewed by the school Superintendent, Principal or Dean of Students.
Date of Incident *
MM
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DD
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YYYY
Time of Incident (for example, after 2nd hour)
Your answer
Location of incident *
Required
Names of People Involved: *
Your answer
Please report the details of the incident: *
Your answer
This incident can be described the following way: *
This is the Bullying Reporting Site. However this site is only monitored on school calendar days. This is not a crisis line. If you have immediate safety concerns involving a physical threat, suicidal thoughts or threats, or concerns about a weapon or anyone’s immediate physical safety, please call 911 *
Required
Name of person reporting *
Your answer
Contact information: (example cell phone 320-555-1212, call after 5 PM) *
Your answer
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